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Bad Teeth: Excessive Extractions

Extractions versus Treatment

Tooth extraction is the preferred method of treatment for many folks. Not by choice really.... but rather circumstance.

Finances, mild aversions to routine dental treatment, disregard of some of the most basic oral health habits and perhaps just plain stubborness causes many patients to accumulate too many missing teeth.

Basic dental function disappears, tooth breakage (of remaining teeth) due to erratic occlusal and jaw repositioning events and periodontal - gingival tissue damage caused by unopposed teeth ensues for many patients.

Multiple tooth replacements are usually required, consisting of bridgework, fixed bridges, implant supported or retained dentures and possibly partials. Missing bone and soft tissues may require augmentation or grafting surgeries.

This gallery contains several examples of too many extractions... too many missing teeth in both the maxilla (upper jaw) and mandible (lower jaw).

An extreme example of what the overuse of extraction dentistry ("an affordable pretend treatment") can do to the upper arch of a young adult. What makes this example unique is the amount of bone loss.... which is quite severe. Eating habits, food preferences, smoking, medication programs and basic oral hygiene habits can accelerate the loss of critical tissue.

Recreating a natural smile for this patient could include the use of dental implants, bridgework or a partial. The use of implant technology however would require significant bone grafting / augmentation in the affected area.

Upper arch bone loss
Disappearing Bone - Excessive Extractions
Dr. Richward Winter, Milwaukee WI

If you have ever wondered what can happen if you don't treat extractions on a timely basis.... or if you have ever wondered if there is any truth to the claim that dental implants do a good job of preserving and maintaining healthy jawbone.... this picture says it all.

The underlying jaw bone for this patient's upper left arch no longer exists.

Treatment choices could include radical grafting surgeries that incorporates block grafts, with solid blocks of bone material taken from the chin or hip, followed up with choices of removable prosthetics or fixed bridges. A cantilevered bridge, depending upon how much bone is grafted, may also be a treatment choice.

Resorbed Upper Jawbone

Several extractions over the years caused a change in occlusion and shift in bite. Additional teeth are breaking off as a result. Needless to say.... eating normal foods is quite difficult. Enjoying a steak or taking a bite out of an apple is out of the question.

Luckily, the patient has not suffered as much bone loss as would be expected, at least in the anterior area of the upper jaw.

Treatment choices could include grafting surgeries, dental implants, mini implants, fixed bridges, implant anchored or retained denture products and partials.

No Front Teeth
No Front Teeth
Corinne Scalzitti, DMD, MAGD

Another good example of no bite left. Soft foods requiring little or no chewing limit the choices of favorite things to eat. Bone loss, as can be seen in this picture, is quite significant on the lower arch. The upper arch has not sustained as much bone loss although unusual wear on remaining teeth is evident..

Treatment choices could include bone and soft tissue augmentation for the healthier areas of the lower jaw, use of implant devices or locator device attachments to remaining lower teeth that are proven to be sound and firmly rooted, denture prosthetics, possible fixed bridge.

No Bottom Teeth Picture
No Lower Front Teeth
Corinne Scalzitti, DMD, MAGD

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